Sunny Care

Allegation investigated: -Facility staff did not adhere to COVID protocols -Facility staff did not provide a safe environment for the residents. -Facility staff did not properly dispose of hazardous materials.

Licensing Program Analyst (LPA) Ruth Martinez conducted an unannounced visit to the facility to conclude investigation into the above identified complaint allegations. LPA arrived at the facility and was greeted at the door and granted entry. LPA spoke with Adriel Pao, Administrator, and explained the purpose of the visit. Findings are based upon this investigation which included tour of the facility, facility file review, interviews conducted, and copies of pertinent records. It is alleged that facility staff did not adhere to COVID protocols, specifically to facility having visitors. LPA conducted a visit on September 13, 2021, and upon entry was screened for covid as part of their protocol. Interview with 3 of 3 staff stated that facility is cleaned and disinfected 3-4 times a day which includes Continued on LIC9099-C Unsubstantiated sanitizing frequently touched surfaces such as tables, doorknobs, light switches, counter tops, handles, toilets and sinks. Equipment that is shared amongst residents is cleaned and disinfected. Visitors are screen and are asked to wear a mask and/or if they are outside, they don’t wear a mask. Facility staff celebrate birthdays for residents and staff but are done outside with social distancing. The most recent birthday was for the Administrator but it was conducted outside of the facility with social distancing. There was no music and there was no issues. LPA conducted a tour of the facility and observed Clorox wipes, Clorox based products and disinfectants. LPA observe facility had a supply of at least 30 days of PPE. LPA also observed staff and residents with face mask at the time of visit. It is alleged that facility staff did not provide a safe environment for the residents. Per complaint intake detail indicates that there was police presence on August 21, 2021. Per interview with staff stated that there was an incident with a resident that required 911 to be called and resident to be sent out to the hospital for further treatment. Incident involved one resident and did not interfere with or affect the other four residents at the facility. Per record review it was indicated that Administrator sent in an LIC624 unusual incident report on August 23, 2021, notifying CCLD about an incident with a facility resident. 911 was called immediately and incident was handled appropriately and with proper time for immediate attention. It is alleged that facility did not properly dispose of hazardous materials specifically to insulin pens being disposed of. LPA Martinez inspected residents’ medication and observed that facility had resident with diagnosis of diabetes but were only on metformin. LPA did not observe any resident to have a prescription for insulin or any insulin pens within the facility premises. Interview with staff stated that they have residents with diabetes, but they are only on pill based medication and not any injectable. Based on the information mentioned above, the Department is unable to ascertain if the allegations occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations that occurred; therefore, these allegations are deemed Unsubstantiated. An exit interview was conducted with the Administrator and a copy of this LIC9099 report was left at facility.the state’s words, verbatim · CDSS document, Jan 22, 2026 · control 22-AS-20210908084952

Type of visit: Required - 1 Year

On December 9, 2025, at 1:00 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by staff. LPA Kim met with Licensee (LI) Adriel Pao and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents of which one may be bedridden and have a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, two (2) staff room, two (2) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant. There were no bodies of water. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 106.5 degrees F. A comfortable temperature of 72 degrees F was maintained in the facility. Evaluation Report Continues on LIC 809-C LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has two (2) fire extinguishers that are charged and mounted in the kitchen and the garage, and both extinguishers were last inspected on July 11, 2025. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (657-363-8436) and a device used for video teleconference purposes remain available. Certificate of Liability Insurance is effective December 19, 2024, to December 19, 2025. Emergency Disaster drills are conducted quarterly and was last conducted on December 3, 2025. LPA Kim conducted an audit of resident files (R1-R5), staff files (S1-S5), and medication administration record that were all in order and complete. LPA Kim conducted interviews with three (3) residents and three (3) staff. No deficiencies were cited during the inspection visit. An exit interview was conducted, and a copy of this report was provided to Licensee Adriel Pao.the state’s words, verbatim · CDSS document, Dec 9, 2025

Type of visit: Required - 1 Year

On December 20, 2024, at 8:50am, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Bibina Linaza. LPA Kim met with Licensee (LI) Adriel Pao and explained the purpose of the visit. The facility is licensed to operate for six (6) nonambulatory residents of which one may be bedridden and have a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, two (2) staff room, two (2) bathrooms, living area, dining area, kitchen, outdoor covered patio, and an attached two car garage. LPA Kim toured inside and outside of the physical plant with LI Pao. There were no bodies of water. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident's personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 109.9 degrees F to 110.3 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility. LPA Kim observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, emergency water, and emergency supplies are stored in the garage. The facility has two (2) fire extinguishers that are charged and mounted in the kitchen and the garage, and both extinguishers were last inspected on July 11, 2024. Evaluation Report Continues on LIC 809-C During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The smoke detectors and carbon monoxide detectors were operable. A working telephone (657-363-8436) and a device used for video teleconference purposes remain available. LPA Kim conducted an audit of resident files (R1-R6), staff files (S1-S7), and medication administration record. LPA Kim conducted four (4) resident interviews and three (3) staff interviews. Deficiencies were cited during this visit as per Title 22 Division 6 Chapter 8 of the California Code of Regulations. A technical violation was issued at the time of the visit. An exit interview was conducted, and a copy of this report and appeal rights were provided to Licensee Adriel Pao.the state’s words, verbatim · CDSS document, Dec 20, 2024

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.